Fri Jul 01 2022

124 articles - From Friday Jun 24 2022 to Friday Jul 01 2022

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Guidelines

Guidelines, position statements, white papers, technical reviews, consensus statements, etc…

Gastroenterology

AGA Clinical Practice Guideline on the Pharmacological Management of Irritable Bowel Syndrome With Constipation.

The panel agreed on 9 recommendations for the management of patients with IBS-C. The panel made a strong recommendation for linaclotide (high certainty) and conditional recommendations for tenapanor, plecanatide, tegaserod, and lubiprostone (moderate certainty), polyethylene glycol laxatives, tricyclic antidepressants, and antispasmodics (low certainty). The panel made a conditional recommendation against the use of selective serotonin reuptake inhibitors (low certainty).

Pubmed   Journal   ReadQx 

AGA Clinical Practice Guideline on the Pharmacological Management of Irritable Bowel Syndrome With Diarrhea.

The panel agreed on 8 recommendations for the management of patients with IBS-D. The panel made conditional recommendations for eluxadoline, rifaximin, alosetron, (moderate certainty), loperamide (very low certainty), tricyclic antidepressants, and anstispasmodics (low certainty). The panel made a conditional recommendation against the use of selective serotonin reuptake inhibitors (low certainty).

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J Hepatol

EASL Clinical Practice Guidelines on Sclerosing Cholangitis.

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Meta-analysis

meta-analyses and systematic reviews

Aliment Pharmacol Ther

Meta-analysis: efficacy of exclusive enteral nutrition as induction therapy on disease activity index, inflammation and growth factors in paediatric Crohn's disease.

Adherence to EEN can have significant, beneficial effects as induction therapy in paediatric patients with CD.

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Meta-analysis: global prevalence, trend and forecasting of non-alcoholic fatty liver disease in children and adolescents, 2000-2021.

The prevalence of paediatric NAFLD varies by region and is 52.49% overall among the obese population and 7.40% in the general population. It is predicted to reach 30.7% by 2040.

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Meta-analysis: Risk of hepatitis C virus infection associated with hospital-based invasive procedures.

Various invasive procedures were significantly associated with HCV infection. Our results provide a ranking of procedures in terms of HCV risk that may be used for prioritisation of infection control interventions, especially in high HCV prevalence settings.

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Clin Gastroenterol Hepatol

What Is the Prevalence of Clinically Significant Endoscopic Findings in Subjects with Dyspepsia? Updated Systematic Review and Meta-analysis.

Erosive esophagitis was the most common clinically significant finding at EGD whereas gastro-esophageal cancers were rare. Most pathology, including esophagitis and cancer, were found in similar proportions in both groups. These findings support non-invasive approaches to managing dyspepsia in the community with EGD reserved for those at high risk of malignancy.

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Gastroenterology

Proactive Therapeutic Drug Monitoring vs. Conventional Management for Inflammatory Bowel Diseases: A Systematic Review and Meta-analysis.

Routine proactive TDM to target biologic concentration to specific thresholds, regardless of disease activity, did not offer clinical benefit in patients with IBD treated with TNFa antagonists in RCTs conducted to date. We cannot exclude the possibility of benefit in disease subtypes and phases of therapy (induction) not represented in these RCT populations.

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Inflamm Bowel Dis

Efficacy of Fecal Microbiota Transplantation in the Treatment of Active Ulcerative Colitis: A Systematic Review and Meta-Analysis of Double-Blind Randomized Controlled Trials.

FMT demonstrated a clinical and endoscopic benefit in the short-term treatment of active ulcerative colitis, with a comparable safety profile to placebo. Future RCTs are required to standardize study protocols and examine data on maintenance therapy.

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The Role of Appendicectomy in Ulcerative Colitis: Systematic Review and Meta-Analysis.

Prior appendicectomy reduces risk of future colectomy. A reciprocal increased risk of CRC/HGD may be due to prolonged exposure to subclinical colonic inflammation. The results warrant further research, as consideration may be put toward incorporating a history of appendicectomy into IBD surveillance guidelines. A potential role for therapeutic appendicectomy in refractory left-sided UC is also identified.

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J Crohns Colitis

Corrigendum to: Pathogenesis of Microscopic Colitis: A Systematic Review.

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Original articles

RCT, clinical trials, retrospective studies, etc…

Aliment Pharmacol Ther

Chicago classification v4.0 protocol improves specificity and accuracy of diagnosis of oesophagogastric junction outflow obstruction.

CCv4.0 criteria reduced the prevalence of EGJOO by 80%, thereby refining the diagnosis and identifying clinically relevant outflow obstruction. Elevated RDC-IRP can predict conclusive EGJOO per CCv4.0.

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Children included in randomised controlled trials of biologics in inflammatory bowel diseases do not represent the real-world patient-mix.

Most children with IBD who initiate biologics would not have been eligible to be included in the corresponding regulatory RCTs. The outcomes of ineligible patients were worse than for eligible patients. Results from RCTs should be interpreted with caution when applied to clinical practice.

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HERACLIS-TAF: a multicentre prospective cohort study on 2-year safety and efficacy of tenofovir alafenamide in patients with chronic hepatitis B with renal and/or bone disorders or risks.

In mostly switched patients with renal and/or BMD disorders/risks, eGFR improved after 12-24 months of TAF treatment, especially in patients with baseline eGFR 30-60ml/min. TAF may also improve low serum phosphate, BMD and ALT, whereas it maintains or induces virological suppression.

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Inflammatory bowel disease patient-reported quality assessment should drive service improvement: A national survey of UK IBD units and patients.

This extensive patient and healthcare provider survey emphasises the importance of aspects of care less often measured by clinicians, such as communication, shared decision-making and provision of information, and demonstrates that IBD nurse specialists are crucial to meeting the needs of people living with IBD.

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Paternal use of medications for inflammatory bowel disease and the risk of hospital-diagnosed infections in the offspring: A nationwide cohort study.

Fathers' use of anti-inflammatory/immunosuppressive medications before conception was not significantly associated with childhood infections. These results fill an important research gap regarding paternal medication safety.

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Rectal hyposensitivity: A common pathophysiological finding in patients with constipation and associated hypermobile Ehlers-Danlos syndrome.

Rectal hyposensitivity is a common pathophysiological factor in females with FC and hEDS/HSD as confirmed in two separate cohorts. The rectal hyposensitivity may be due to altered rectal biomechanics/neuronal pathway dysfunction. Management may be better focused on enhancement of sensory perception (e.g., sensory biofeedback).

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Switching to tenofovir alafenamide for nucleos(t)ide analogue-experienced patients with chronic hepatitis B: Week 144 results from a real-world, multicentre cohort study.

Switching to TAF remained effective and safe for up to 3years. Given the increasing comorbidities related to ageing, it will be important to carefully follow the change in the lipid levels of patients with a prior TDF-based regimen.

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Synchronous occurrence of different polyp types during colonoscopy.

Different types of colon polyps commonly coincide in individual patients. The present set of data from a large nationwide database may provide guidance for the endoscopist of what variety in colon polyps to expect during colonoscopy.

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The association between inflammatory bowel disease and mental ill health: A retrospective cohort study using data from UK primary care.

Deliberate self-harm, depression, anxiety and insomnia were more frequent among patients with IBD. IBD is independently associated with an increased risk of deliberate self-harm.

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Understanding anti-TNF treatment failure: Does serum triiodothyronine-to-thyroxine (T3/T4) ratio predict therapeutic outcome to anti-TNF therapies in biologic-naïve patients with active luminal Crohn's disease?

Lower baseline serum fT3/fT4 ratio was associated with female sex, corticosteroid use and disease activity. It predicted PNR to anti-TNF treatment at week 14, but not non-remission at week 54.

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Clin Gastroenterol Hepatol

Association of Statin Usage and the Development of Diabetes Mellitus after Acute Pancreatitis.

In a large database-based study, statin usage reduced the risk of developing DM after acute pancreatitis. Further prospective studies with long-term follow-up are needed to study the impact of statins on acute pancreatitis and prevention of PPDM.

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Dosing of Rifaximin Soluble Solid Dispersion Tablets in Adults With Cirrhosis: 2 Randomized, Placebo-Controlled Trials.

Rifaximin SSD IR 40 mg may reduce hospitalizations in patients with cirrhosis and shorten duration of OHE during hospitalization-considered a negative finding, yet also hypothesis-generating (ClinicalTrials.gov NCT01904409; NCT03515044).

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Endoscopy

Anchoring endoscopic mucosal resection vs conventional endoscopic mucosal resection for large nonpedunculated colorectal polyps: A randomized controlled trial.

A-EMR was superior to C-EMR for the complete resection of large colorectal polyps. A-EMR can be considered one of the standard methods for the removal of colorectal polyps with sizes of 10 mm or greater.

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Gastroenterology

Exhaustion of CD39-expressing CD8+ T cells in Crohn's disease is linked to clinical outcome.

These data show a role for the exhaustion of peripheral CD39-expressing CD8 T cell subsets in CD. Their low frequency illustrates the utility of single-cell cytometry methods for identification of relevant immune populations. Importantly, the link of their exhaustion status to the clinical activity and their specific gene signatures have implications for exhaustion-based personalized medicine approaches.

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Western-style Diet, pks Island-Carrying Escherichia coli, and Colorectal Cancer: Analyses from Two Large Prospective Cohort Studies.

Western-style diet is associated with higher incidence of colorectal cancer containing abundant pks+ E. coli, supporting a potential link between diet, the intestinal microbiota, and colorectal carcinogenesis.

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Gut

Activation of NOTCH signaling via DLL1 is mediated by APE1-redox-dependent NF-B activation in oesophageal adenocarcinoma.

These findings underscore a unique mechanism that links redox balance, inflammation and embryonic development (NOTCH) into a common pro-tumorigenic pathway that is intrinsic to EAC cells.

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Double-blinded randomised placebo controlled trial of enterosgel (polymethylsiloxane polyhydrate) for the treatment of IBS with diarrhoea (IBS-D).

Enterosgel is safe and effective in IBS-D, providing an alternative to the limited current treatment options.

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Temporality of body mass index, blood tests, comorbidities and medication use as early markers for pancreatic ductal adenocarcinoma (PDAC): a nested case-control study.

Risk of PDAC increased with raised HbA1c, liver markers, white blood cell and platelets, while followed a U-shaped relationship for BMI and haemoglobin. BMI and HbA1c derange biphasically approximately 3 years prior while liver markers and blood counts (white blood cell, platelets) derange monophasically approximately 1 year prior to PDAC. Profiling these in combination with their temporality could inform earlier PDAC diagnosis.

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Hepatology

Apolipoprotein F Is Reduced in Humans with Steatosis and Controls Plasma Triglyceride-Rich Lipoprotein Metabolism.

These data reveal a previously undescribed role for ApoF in the control of plasma and hepatic lipoprotein metabolism by favoring VLDL-TG secretion and hepatic lipoprotein remnant particle clearance.

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Fatty liver disease is not associated with increased mortality in the elderly - A prospective cohort study.

The presence of fatty liver disease was not associated with mortality in this cohort nor in a range of subgroups. This indicates that screening for fatty liver disease and/or fibrosis is unlikely to improve outcomes among the elderly population.

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HBV Transcription and Translation Persist Despite Viral Suppression in HBV-HIV Co-Infected Patients on Antiretroviral Therapy.

HBcAg and HBsAg IH staining persisted despite viral suppression, and IH grades and staining patterns correlated with markers of transcription (HBV RNA) and translation (HBcrAg). These data indicate that apparent HBV suppression is associated with residual transcription and translation that could contribute to liver pathology. Additional antiviral strategies directed to HBV protein expression may be useful to ameliorate liver injury.

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Macrophage-specific fibroblast growth factor 12 promotes liver fibrosis progression in mice.

FGF12 is a novel factor to promote liver fibrosis progression. Therapeutic approaches to inhibit macrophage FGF12 may be used to combat liver fibrosis in the future.

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Inflamm Bowel Dis

Appendix and Ulcerative Colitis: a Key to Explaining the Pathogenesis and Directing Novel Therapies?

In summary, recent literature suggests a possible role for microbes and immune cells within the appendix; however, the role of the appendix in the pathogenesis of UC remains unclear. Further research could clarify the therapeutic potential related to this organ.

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MiRNA-Based Therapies for the Treatment of Inflammatory Bowel Disease: What Are We Still Missing?

The accumulating data have pushed miRNA-based therapy closer to clinical practice, although many open questions remain. With this systematic review, we discuss the current knowledge about the therapeutic effects of miRNAs mimicking and inhibition, and we explore the new potential targets of miRNA family for the treatment of inflammation and fibrosis in IBD.

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The Performance of the Rutgeerts Score, SES-CD, and MM-SES-CD for Prediction of Postoperative Clinical Recurrence in Crohn's Disease.

The SES-CD and MM-SES-CD perform similarly to the Rutgeerts score for predicting subsequent CR of postoperative CD. The MM-SES-CD threshold of =26 was predictive of postoperative CR. Clinicians and trialists could consider using the SES-CD or MM-SES-CD to assess postoperative CD given their ability to capture colonic disease recurrence and predict CR.

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J Crohns Colitis

The impact of COVID-19 on patients with IBD in a prospective European cohort study.

No increase in either COVID-19 or severe COVID-19 incidences were observed in patients with IBD. There was no impact of COVID-19 on IBD-related medication and clinical activity. Access to endoscopy and imaging was restricted during the first months of the first COVID-19 outbreak.

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J Hepatol

Multimodal single-cell profiling of intrahepatic cholangiocarcinoma defines hyperactivated Tregs as a potential therapeutic target.

Interfering with hyperactivated Tregs should be explored to enhance anti-tumor immunity in iCCA.

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NUDT1 promotes the accumulation and longevity of CD103+ TRM cells in primary biliary cholangitis.

Methods Phenotypic and functional analysis of intrahepatic T cell subsets were performed by flow cytometry. CD103 + T cells, which could be exploited therapeutically.

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Soluble TREM2 levels reflect the recruitment and expansion of TREM2+ macrophages that localize to fibrotic areas and limit NASH.

Our study highlights the functional properties of bone marrow-derived TREM2 + macrophages and implies the clinical relevance of systemic soluble TREM2 levels in the context of NASH.

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TREM-2 plays a protective role in cholestasis by acting as a negative regulator of inflammation.

TREM-2 acts as a negative regulator of inflammation during cholestasis, representing a novel potential therapeutic target.

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Whole blood microRNAs capture systemic reprogramming and have diagnostic potential in patients with biliary tract cancer.

WB miRNA profiles are altered in patients with BTC. Quantification of miRNA indexes in combination with serum CA 19-9 has potential to improve early diagnosis of BTC, pending further validation.

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Reviews&Editorials

Plenty of the editorials are available as full text through the publisher website using the provided link

Aliment Pharmacol Ther

Editorial: higher levels of certain serum bile acids in non-alcoholic fatty liver disease-new insights from Guatemala.

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Editorial: intravenous to subcutaneous vedolizumab-switch without glitch!

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Editorial: it's time to standardise competencies in intestinal ultrasound.

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Editorial: lack of gastrointestinal symptoms caused by gluten in patients without coeliac disease-time to ditch the 'gluten' from 'non-coeliac gluten sensitivity'.

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Editorial: measuring fertility in men with inflammatory bowel disease.

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Editorial: optimising hepatitis B vaccine response in inflammatory bowel disease-time to get some skin in the game.

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Editorial: risk of gastric and duodenal ulcers among new users of low-dose aspirin.

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Editorial: STAT3 phosphorylation for tofacitinib monitoring in ulcerative colitis-a step towards precision medicine?

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Editorial: the CTA on EGIDs.

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Editorial: the impact of red blood cell transfusion on inpatient mortality in upper gastrointestinal bleeding.

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Review article: Novel biomarkers in hepatitis B infection.

Novel viral biomarkers have the potential to provide additional insights into the natural history of infection and allow a more bespoke, cost-effective framework of care. However, access remains limited, and further efforts are needed to validate their use in ethnically diverse populations, confirm predictive cut-off values, and establish their role in the era of novel antiviral therapies.

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Am J Gastroenterol

Preventing Postendoscopic Mucosal Resection Bleeding of Large Nonpedunculated Colorectal Lesions.

We also provide recommendations for steps that can be taken before, during, and after EMR to minimize bleeding risk. Finally, this review proposes future directions to reduce CSPEB incidence.

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Hepatology

Hepatocellular Carcinoma Down-Staging for Liver Transplantation in the Era of Systemic Combined Therapy with Anti-VEGF/TKI and Immunotherapy.

Recent advances in systemic treatments including immune checkpoint inhibitors alone or in combination with tyrosine kinase inhibitors have prompted the discussion regarding their role for downstaging disease prior to transplantation. Here, we provide a review of prior locoregional approaches for downstaging, novel systemic agents and their role for downstaging and finally, key and critical considerations of the assessment, endpoints and optimal designs in clinical trials to address this key question.

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Implementation of a Controlled Human Infection Model for Evaluation of HCV Vaccine Candidates.

Importantly, the study design (including number of volunteers required, cost, duration of study and risk to volunteers) varies significantly depending on the proposed mechanism of action (sterilizing/rapid viral clearance vs delayed viral clearance) of the vaccine under evaluation. We conclude that an HCV CHIM is now realistic, that safety and ethical concerns can be addressed with the right study design, and that without an HCV CHIM it is difficult to envisage how the development of an HCV vaccine will be possible.

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The Digital Determinants of Liver Disease.

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What is Hepatology looking for Version 2.0?

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J Hepatol

BULEVIRTIDE WITH OR WITHOUT PEGIFNa FOR PATIENTS WITH COMPENSATED CHRONIC HEPATITIS DELTA: FROM CLINICAL TRIALS TO REAL LIFE STUDIES.

These encouraging yet preliminary findings must be taken with caution as many critical issues related to this new antiviral strategy are still poorly understood as summarized by this review. While waiting for new anti-HBV and anti-HDV drugs to become available for combination studies, BLV treatment is the only currently available anti-HDV therapeutic option that might improve the long-term prognosis of difficult-to-manage patients such as those with CHD.

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EASL innovation award recipient 2022: Prof. Martin Rössle.

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EASL International Recognition Award Recipient 2022: Prof. Patrick S. Kamath.

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EASL International Recognition Awardee 2022: Dr. Pere Ginès.

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EASL Recognition Award Recipient 2022: Dr Sophie Lotersztajn.

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Immune mechanisms linking metabolic injury to inflammation and fibrosis in fatty liver disease - novel insights into cellular communication circuits.

We propose a refined concept by which the immune system contributes to al stages of NAFLD and discuss open scientific questions arising from this paradigm shift that need to be unraveled in the coming years, being a basis for reliable diagnosis, prognosis of patients at risk. Finally, we discuss novel therapeutic avenues targeting the multiple triggers of inflammation, including combination therapy via nuclear receptors (FXR agonists, PPAR agonists).

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Signed, SEALed, detected I'm your patient with advanced fibrosis or cirrhosis!

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Thriving in turbulent times: EASL reflects on 2021, looking to 2022 and beyond.

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Letters&Replies

Letters to the editors and authors’ replies

Aliment Pharmacol Ther

Editorial: higher levels of certain serum bile acids in non-alcoholic fatty liver disease-new insights from Guatemala.Authors' reply.

Pubmed   Journal   ReadQx 

Editorial: intravenous to subcutaneous vedolizumab-switch without glitch! Authors' reply.

Pubmed   Journal   ReadQx 

Editorial: lack of gastrointestinal symptoms caused by gluten in patients without coeliac disease-time to ditch the 'gluten' from 'non-coeliac gluten sensitivity'. Authors' reply.

Pubmed   Journal   ReadQx 

Editorial: optimising hepatitis B vaccine response in inflammatory bowel disease-time to get some skin in the game. Authors' reply.

Pubmed   Journal   ReadQx 

Editorial: the CTA on EGIDs-author's reply.

Pubmed   Journal   ReadQx 

Editorial: the impact of red blood cell transfusion on inpatient mortality in upper gastrointestinal bleeding-authors' reply.

Pubmed   Journal   ReadQx 

Letter: association of circulating bile acid concentrations and non-alcoholic fatty liver disease-authors' reply.

Pubmed   Journal   ReadQx 

Letter: association of circulating bile acid concentrations and non-alcoholic fatty liver disease.

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Letter: gut-brain axis dysfunction underlies symptom generation in irritable bowel syndrome-a plea for rational interpretation of irrational doses of FODMAPs.

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Letter: gut-brain axis dysfunction underlies symptom generation in irritable bowel syndrome-a plea for rational interpretation of irrational doses of FODMAPs. Authors' reply.

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Letter: is it appropriate to use a fatty liver index >60 as an alternative criterion for non-alcoholic fatty liver disease?

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Letter: is it appropriate to use a fatty liver index >60 as an alternative criterion for non-alcoholic fatty liver disease? Authors' reply.

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Letter: pancreatic involvement in inflammatory bowel disease-authors' reply.

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Letter: pancreatic involvement in inflammatory bowel disease.

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Letter: progressive weakening of the concept that gluten has a detrimental effect on mental health and gut symptoms in the absence of coeliac disease-authors' reply.

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Letter: progressive weakening of the concept that gluten has a detrimental effect on mental health and gut symptoms in the absence of coeliac disease.

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Gastroenterology

Reply: Challenging the dogma of -3 polyunsaturated fatty acids.

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Response to letter.

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Gut

Transcolonic natural orifice transluminal endoscopic surgery (NOTES) is a promising technique for but not limited to periappendiceal lesions.

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Hepatology

Letter to the Editor: Is eliminating METTL1-mediated accumulation of PMN-MDSCs sufficient to prevent HCC recurrence after RFA?

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Letter to the Editor: The novel perspectives of GLP-1/GLP-2 receptors against NASH via the diverse regulation.

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Letter to the Editor: Using intratumoral steatosis to predict the efficacy of combination therapy in nonviral hepatocellular carcinoma.

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J Hepatol

Are there any reliable predictors of unreported alcohol consumption in MAFLD patients?

Pubmed   Journal   ReadQx 

Low accuracy of FIB-4 test to identify people with diabetes at low risk of advanced fibrosis.

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Others

all remaining publications eg case reports, images of the month, etc…

Am J Gastroenterol

Calendar of Courses, Symposiums and Conferences.

Pubmed   Journal   ReadQx 

Lung Infection in Severe Alcohol-related Hepatitis: Not to be Underestimated.

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Proton Pump Inhibitors and Risk of Mortality: Longer and More Dangerous?

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Response to Angadi and Giri.

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Response to Yoo and Sonnenberg & Braillon.

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Response to Zhou.

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Two Times Tiny Is Still Small.

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Endoscopy

A 3-Fr microcatheter is suitable for a 0.018-inch guidewire during endoscopic ultrasound-guided biliary drainage.

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An unexpected adverse event during gastrointestinal endoscopy involving retrieval of dislodged endoscopic suture material from the trachea.

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Author commentary on Diogo Libânio et al.

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Author commentary on Pierre Lafeuille et al.

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Author commentary on Sabela Carballal et al.

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Combined ERCP and endoscopic ultrasound-guided antegrade stenting for hilar biliary obstruction in a patient after pancreatoduodenectomy.

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Complete closure of a large mucosal defect (100mm) after gastric endoscopic submucosal dissection, using the "accordion fold" method.

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Delayed-onset bleeding after transrectal prostate biopsy presenting as a rectal Dieulafoy's lesion.

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Direct large flow of venous gas into right atrium and ventricle during endoscopic biliary treatment.

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Endoscopic ultrasound-guided gastrojejunostomy and choledochoduodenostomy with lumen-apposing metal stents: an efficient approach to double endoscopic bypass.

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First report of closure of an iatrogenic recto-vesical fistula solely using endoscopic negative pressure therapy.

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Freehand endoscopic ultrasound-guided transrectal drainage of diverticulitis-associated abscess with electrocautery-enhanced lumen-apposing metal stent under spinal anesthesia.

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Gel-immersion endoscopic detorsion for pediatric sigmoid volvulus.

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In difficult biliary cannulation, how quickly should we be reaching for the second wire?

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Reply to Dhar et al.

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To stent or not to stent: do we have an answer yet?

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Underwater endoscopic mucosal resection for a protruding lesion in the esophagus.

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Unusual diagnosis of malignant melanoma via cholangioscopy.

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Gastroenterology

Counting calories, hours or both: Is time-restricting eating efficient for weight loss?

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On the Importance of Safe Access to Reproductive Options for Adolescents and Women with Liver Disease.

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Gut

Bacteria as key players in primary sclerosing cholangitis?

Pubmed   Journal   ReadQx 

Inflamm Bowel Dis

Comparison of the Relative Sensitivity of Clinical, Endoscopic, and Histologic Remission for Detection of Treatment Efficacy in Ulcerative Colitis Trials.

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De Novo Pediatric Ulcerative Colitis Triggered by SARS-CoV-2 Infection: a Tale of 2 Sisters.

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Hyperbaric Oxygen as Successful Monotherapy for a Severe Ulcerative Colitis Flare.

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Myocardial Infarction With Nonobstructive Coronary Arteries in New-onset Inflammatory Bowel Disease.

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Surgical Management of Enterovesical Fistula in Crohn's Disease in the Biologic Era.

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J Crohns Colitis

Serum Monitoring of Recurrence in Post-Operative Crohn's Disease: Have We Arrived?

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